Up to 3% of the world population is infected with hepatitis C virus (HCV), a hepatotropic RNA virus that causes acute and chronic hepatitis as well as cirrhosis and hepatocellular carcinoma. HCV infection results in chronicity in most cases (85%) despite detectable antiviral immune response, and recent studies suggest that virus-specific T cells play an important role in the outcome of HCV infection. Interestingly, HCV infection is up to 7 fold more prevalent in alcoholic individuals than in the general population, and chronic alcohol use in HCV-infected patients is associated with accelerated liver disease progression and development of liver cancer. While alcohol is known to suppress cellular immune response, little is known about the effect of alcohol on HCV-specific T cell response in HCV-infected patients. Therefore, the primary aim of this application is to determine if chronic alcohol use results in a pathogenetic HCV-specific T cell response that promotes further liver damage than virus control. In addition, we will determine the extent to which this may be reversed upon alcohol cessation.